Irvin Errol Jondahl, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J5363 Issued in TX

Practice address

1014 Memorial Dr
1St Floor
Denison, TX 75020-2079

Phone

(903) 416-6000

Fax

(903) 416-6183

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Texomacare

  • Family Medicine Physician
  • Denison, TX
  • NPI 1740233592
  NPD (past)
• Uhs of Texoma Inc

  • Home Health Agency
  • Durant, OK
  • NPI 1437782406
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1912935958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 MEMORIAL DR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750202079",
            "telephone_number": "903-416-6000",
            "fax_number": "903-416-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 MEMORIAL DR",
            "address_2": "1ST FLOOR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750202079",
            "telephone_number": "903-416-6000",
            "fax_number": "903-416-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONDAHL",
        "first_name": "IRVIN",
        "middle_name": "ERROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J5363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099255401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Van Wagoner MD
• Johnny Grinspan Inc
• Debbie Johnson, R.N.
• Quyen Johnson, NP
• Dana Joines, MS, CCC-SLP
• Courtney Jones
• Courtney Jean Jones, SLP-I
• Jessica Jones
• Shelly Jones, COTA
• Brandee R Jordan, LCSW-S

• Family Medicine Physician in Denison, TX
• Providers in Denison, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.